Hospital exec: Too many EMR features tied to billing

In spite of their benefits, electronic medical records are flawed because so many of their features are tied to billing, not care, a cardiologist writes in a recent blog post published to KevinMD.com.

Ira Nash, senior vice president and executive director at North Shore-LIJ Medical Group, says that "nearly all of the things that doctors dislike about [EMRs] are 'features' designed to capture information needed for billing purposes. That is, they are all about documenting what we did to or for the patient, not about how the patient was doing."

Nash recalls an EMR he saw at one primary-care practice that was little more than a "medication list and an annotated problem list, with narrative added to each problem as needed."

Doctors (and EMRs), he adds, "are getting killed by the focus on process," when the focus, he says, should be on outcomes.

Focusing on caring for a population of people and being judged on appropriately adjusted outcomes could free doctors "from the stifling limitations of so many contemporary EMRs, while still enjoying the benefits they can provide for us and our patients," Nash writes.